The Journey

The Depression of Age
By Kaitlin Jones

Clarence Guilge has a mischievous Glint in his eye as he hands his guests a small piece of paper containing a joke:

"A nun went to pick up medical supplies, but on the way back, her car ran out of gas. Having just passed a gas station, she walked back and asked for 2 gallons. The attendant said the station had sold its last gas can, so she would need to find something to put the gas in.

Dejected the nun started back to her car when she realized that she had a bed pan among the medical supplies. She took the bedpan to the station, put her gas in it and walked back to her car.

As the nun poured from the bedpan into the tank two men watching from across the street looked at each other in amazement before one said, "if that blasted car starts, I'm going to become a Catholic!"

This joke is one of several that Guilge has printed off his new computer to give to those he meets.

"Every day at dinner we sit with someone new at dinner at coffee, you meet all sorts of new people from all over," Guilge said. "There's always something new to learn."

Guilge is one of the most social people you'll ever meet. He prowls the corridors of Bishop Place Assisted Senior Living in Pullman, Wash., meeting new people, and visiting his peers daily. As he walks up to the ladies at the front desk, they routinely say, "Here comes trouble," a greeting Guilge pretends to hate, but which always creates a gleam in his eyes.

Constantly playing pranks, Guilge once bought his own blood pressure pump so that he could shock his nurses by giving them his exact blood pressure every day, a practice that ended when the nurses got wise and sent someone up 10 minutes early.

Guilge's story however, isn't the experience of every senior citizen in assisted living.

Further down the hall of Bishop Place a woman named Una walks the Memory Villa, the section of Bishop Place devoted to those who need more extensive medical care. Una routinely walks into other patient's rooms, a confused look on her face. She wanders purposefully around what seems to her like a prison.

"Can you get me out of here?" she says to all those who enter the wing, her large brown eyes heartbreakingly imploring.

Una is one of the many, lost within their own minds, who have fallen into despair and depression. She screams as a nurse tries to sit her down for dinner slapping the nurse's hand and yelling.

"I want to go home to my family!" Una said.

Depression in the elderly is not always brought on from dementia however, it can also be the deteriorating cause of it according to Staying Sharp an AARP and NRTA study. Factors such as lack of mobility, loss of family members, and lack of social interaction, can lead to depression in the older community, as age sets in. The depression these factors bring on can further deteriorate mental acuity in people whose health is already constantly failing.

Epidemiologists estimate that up to 10 percent of patients in primary care over the age of 50 suffer from major depression, and that 20 percent of those patients suffer from dysthmia, or chronic low mood.

This is concerning since depression in the elderly community can lead to major complications. Studies by the National Institute of Mental Health report that older Americans, especially white males over the age of 85 have the highest suicide rate in the United States.

Depression in the older community can also, according to the Journal of Abnormal Psychology, lead to diminished ability to fight off infection and disease two things that occur increasingly more often in the elderly.

Just as concerning is a recent study in the American Journal of Psychiatry found the symptoms of depression can lead to increased limitations on daily activity, and a greater need for care in the elderly. Increased limitations can create yet another issue in patients that may already he held back because of mobility and illness issues since it can lead to a limit in the amount of social interaction found to be key in maintaining mental ability.

Women 78 years or older who maintained larger social networks were found to be 26 percent less likely to develop dementia and other cognitive impairments, than those with smaller social networks, according to a recent study published in the American Journal of Public Health. The research also found that woman with daily contact with friends and family cut their risk of dementia almost in half.

Part of this may be that those who join these social networks are more likely to participate in healthy behaviors such as walking groups, tennis teams, or bowling leagues found to reduce or delay the onset of pathological changes in the brain leading to cognitive impairment.

"Group exercise or independent personal training is great if only for socialization," said Diane Levad, a Spokane fitness specialist and certified personal trainer who works with geriatric patients. "It helps to get them out and make them feel like they have somewhere to so they're not cut off."

Exercise, along with social interaction is believed to stimulate the formation of brain synapses, and enhance the blood flow to the brain, increasing the formation of nerve cells. It's also believed that social interaction can limit the amount of time an ageing brain can remain unfocused in a daydream state. Keeping the brain from spending too much time in a daydream state is important because, as age increases, it becomes more difficult for the aging brain to switch between daydreaming and focus.

To further back up these theories, a Dutch study found that the risk of developing Alzheimer's and decreased mental capacity was higher in individuals who are depressed.

Depression has also been linked to an increase in diseases such as cancer. The Journal of the National Cancer Institute found that individuals suffering from depression six years or longer were 88 percent more likely to develop cancer.

Despite these risks, depression in the elderly continues to goes largely undiagnosed and untreated for several reasons. In most cases, depression can be mistaken for dementia, or can be in conjuncture with the disease, masking the depression symptoms. Depression may also be missed when it is overlooked by professionals only seeking to treat the bodily ailments often found in older patients.

Another problem in diagnosis is created by the older community itself, as their generation often views depression as a shameful secret or weakness, making them the least likely group to seek treatment for their illness according to AARP

Even more barriers are created for those who do seek treatment. As many as 40 percent of older people taking anti depressants quit taking them or miss a dose. The problem occurs because some older adults have an increased sensitivity to the side effects of the drugs, or may be taking other medications which may not mix well with antidepressants.

Many older patients may also suffer from memory problems, making it more difficult for them to keep track of difficult drug regiments. Patients may also have to deal with the gap between the costs that Medicare will cover, and paying out of pocket for the drugs on a fixed income.

These dangers and risks may seem insurmountable, but the reality of depression is that it is a disease with a high success rate for treatment, and as caretakers become more informed and on the lookout for the symptoms of depression, the problem can become less and less prevalent.

"Many people my age want to complain about things, so they complain about things they've got no need to complain about," Guilge said, shaking his head.

Treatment exists for those who are ailing and support exists for those who look for it. By discussing their symptoms with caregivers and joining the social world around them, the older community can find relief from the heart-wrenching problem of depression, and the issues that come with it, prolonging their lives and more importantly, creating a life that is full and exciting.